Parkinson’s disease in Morocco: Rising challenges in diagnosis, treatment and coverage

A Moroccan neurology researcher and head of the Moroccan Association of Parkinson’s Patients has raised concerns over major disparities in access to treatment for Parkinson’s disease in Morocco, warning that patients in rural areas face significant obstacles despite the country’s high-quality neurological care.

Rabia Benaazzouz, a specialist in neurological diseases, said Parkinson’s is a chronic neurodegenerative disorder affecting the central nervous system, characterized by the gradual and progressive loss of dopamine-producing brain cells.

Speaking to Hespress AR, Benaazzouz stressed the importance of distinguishing Parkinson’s disease from atypical Parkinsonian syndromes and other neurological disorders such as Alzheimer’s disease or multiple sclerosis, noting that each condition affects different regions of the brain and requires different treatment approaches.

She explained that Parkinson’s symptoms usually begin asymmetrically, affecting one side of the body before spreading to the other. Key motor symptoms include slowness of movement, muscle rigidity and what is known as “resting tremor,” which appears when the body is still and often decreases during intentional movement.

“Patients often struggle simply to begin moving,” Benaazzouz said. “A person may want to stand up after a meeting, but the brain’s command does not immediately translate into movement.”

Other symptoms include shorter walking steps, smaller handwriting, facial rigidity, balance problems and speech difficulties. As the disease progresses, non-motor symptoms such as depression, sleep disorders, cognitive decline, chronic pain and severe constipation may also appear.

Benaazzouz said symptoms usually become visible only after the brain has lost nearly 60% of its dopamine-producing cells in the substantia nigra, a deep brain region responsible for smooth motor control.

She noted that while the exact cause of Parkinson’s remains unknown, scientists generally agree that it results from multiple factors, including aging, pesticide exposure, repeated head trauma, air pollution, heavy metals and genetic predisposition.

Globally, inherited Parkinson’s cases account for only 5% to 10% of diagnoses, she said. However, Morocco presents a notable exception.

Citing a 2017 study conducted by Prof. Ahmed Bouhouche at the Specialty Hospital in Rabat, Benaazzouz said the country has a significantly higher prevalence of mutations in the LRRK2 gene compared with Europe and the United States, making hereditary factors more prominent in Morocco.

She added that some protective factors, including regular physical activity and caffeine consumption, may reduce the risk of developing the disease.

“There is currently no cure for Parkinson’s anywhere in the world,” Benaazzouz said. “All available treatments aim only to control symptoms and improve quality of life.”

Treatment generally follows three main paths: medication to compensate for dopamine loss, deep brain stimulation surgery for advanced cases and complementary therapies such as physical rehabilitation and speech therapy.

She said deep brain stimulation, which involves implanting electrodes in specific brain areas to regulate abnormal activity, is available in Morocco’s university hospitals in Casablanca, Rabat, Marrakesh, Fez and Tangier.

However, access remains unequal.

According to Benaazzouz, once patients reach a neurologist, the quality of care meets international standards. The main problem lies in geographic and financial access.

Neurologists are concentrated in major cities, leaving rural and mountainous areas underserved. This forces many patients to travel long distances and bear high transportation and accommodation costs, often delaying diagnosis until symptoms become severe.

She also pointed to a shortage of specialists. A 2025 scientific publication involving Moroccan doctors found that Morocco has roughly one neurologist for every 100,000 people, among the best ratios in Africa, but far below developed countries, where the figure ranges from seven to nine per 100,000.

Long waiting times at university hospitals further worsen delays, she said, calling for the creation of specialized movement disorder centers to reduce pressure on existing facilities.

Financial barriers also remain significant. While some insurance systems fully cover costly surgical procedures, patients under broader mandatory health coverage programs often must pay 30% of expenses themselves, an amount many workers and low-income families cannot afford.

Benaazzouz also warned of repeated shortages of essential Parkinson’s medications, forcing some families to search abroad for treatment.

She called for the creation of a national Parkinson’s registry, expanded neurological services across all regions, better training for general practitioners to detect early symptoms and the inclusion of rehabilitation therapies in chronic disease coverage.

She also urged Moroccan authorities to officially recognize Parkinson’s as a disability-causing disease and adopt a national Parkinson’s strategy to improve drug security, equalize treatment access and support local scientific research.

“Malnutrition, poverty and geography should never determine who receives care,” she said. “Parkinson’s is a societal issue, and solving it requires a collective national response.”